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Chapter 1
The Aging Population
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction
• Myths of aging
• Misinformation as an injustice
• Role of the gerontological nurse:
– Know the facts
– Educate the public
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Improvements for Older Adults
• 1914: Dr. I. L. Nascher—“Father of Geriatrics”—
first geriatric textbook
• 1935: Federal Old Age Insurance Law under the
Social Security Act
• 1965: formation of the Administration on Aging,
Older Americans Act, Medicare, and Medicaid
• Continued growing concern for older adults
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Subsets of the Older Adult Population
• Young-old
• Old-old
• Middle-old
• Centenarians
• Diversity rather than homogeneity
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Population Growth and
Increasing Life Expectancy
• Persons 65+ currently represent more than 12%
of the U.S. population
• By the year 2020 older adults will grow to 17%
of the population
• Increasing life expectancy:
– 1930: 59.7 years
– 1965: 70.2 years
– Present: 77.8 years
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Factors Influencing Increased
Life Expectancy
• Advancements in disease control and health
technology
• Lower infant and child mortality rates
• Improved sanitation
• Better living conditions
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Life Expectancy: Race and Gender
• Gap between white people and black people
– Societal issues
– Concern for nurses
• Gap is narrowing between males and females
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Marital Status and Living Arrangements
• Older women are more likely than men to be
married
• Most older adults live with a spouse or other
family member
• More women than men live alone
• Potential for living alone increased with age
• Most older adults have family contact
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Geographic Distribution
• States with the greatest number of older adults:
California, Florida, New York, Texas, and
Pennsylvania
• States with dramatic increases in the past
decade: Nevada, Alaska, Hawaii, and Arizona
• States with the lowest percentage of total
population over age 65: Alaska, Utah, and
Georgia
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Income of Older Adults
• 10% of older adults live below the poverty level
• Older adults dependent on Social Security for
more than half of their income
• Median net worth is twice the national average
related to home ownership
• “Asset rich and cash poor”
• Women and minority groups are poorer than
white men
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Employment and the Older Adult Population
• Declining percentage of workers in the labor
force
• Men leaving the workforce at an earlier age
• Increase in the number of middle-aged women
who are employed
• Increased desire to work at the age of
retirement
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Education
• Increasing levels of education in the older adult
population
• Advanced degrees and higher income
• Impact on health care:
– Older adults will be more informed
consumers
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Health Status of Older Adults:
Acute Conditions
• Fewer acute illnesses
• Lower death rates
• Longer period of recovery
• More complications
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Health Status of Older Adults:
Chronic Conditions
• Major problem that increases with age
• Most have at least one chronic disease; many
have several
• Result in limitations in ADLs and IADLs
• Leading cause of disability and death
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Implications of an Aging Population
• Impact on health and social service agencies
• Need for gerontological nurses
• Future needs
• Payment of services
• Impact and characteristics of the “baby
boomers”
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Provision and Payment of Services
• Higher rates of hospitalization, surgery, and
physician visits
– Paid by federal dollars most often
• Less than 5% of older adults live in a nursing
home, assisted living, or other institutions
• Long-term care payment
• Role of the gerontological nurse
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins